Background to this inspection
Updated
15 July 2016
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
This inspection took place on 10 June 2016. The provider was given 48 hours’ notice of our visit because we wanted to ensure the provider and the manager were available to support the inspection. One inspector carried out the inspection.
Before the inspection we reviewed the evidence we had about the service. This included any notifications of significant events, such as serious injuries or safeguarding referrals. Notifications are information about important events which the provider is required to send us by law. We had not asked the provider to complete a Provider Information Return (PIR) as we were following up concerns identified at the previous inspection. The PIR is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make.
During our inspection we visited the agency’s premises and spoke with the registered provider and the manager. We checked care records for four people, including their assessments, care plans and risk assessments. We checked six staff recruitment files and other records relating to the management of the service, including staff training and induction, the complaints log and quality monitoring checks.
We spoke with 11 people that used the service and seven of their relatives by telephone to hear their views about the care and support provided. We received feedback about the service from one other relative by email. We spoke with nine care workers about the support and training they received to do their jobs.
The last inspection of the service took place on 19 August 2015, when we found the provider was in breach of regulations.
Updated
15 July 2016
The inspection took place on 10 June 2016 and was announced.
Bluebird Care (Elmbridge & Runnymede) provides care and support to people in their own homes. The service provided personal care to 72 older people at the time of our inspection, five of whom were receiving live-in care.
Mr Jonathan Billington is the Director of the business and is registered with the CQC as the Nominated Individual for the provision of personal care. Mr Billington is referred to in this report as ‘the provider’. There was a no registered manager in post at the time of our inspection. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act and associated Regulations about how the service is run. The service manager had begun the process of registering with CQC.
At the last inspection in August 2015, we found the provider was in breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. On two occasions care workers had missed visits, which had serious or potentially serious consequences for people. The agency’s monitoring systems had failed to highlight that care workers had not arrived, which meant no action was taken to ensure that the person received the care they needed or to check the care workers’ safety and welfare.
Following this inspection, the provider submitted an action plan telling us how they would make improvements in order to meet the relevant legal requirements.
At our inspection in June 2016, we found the provider had introduced measures to address these concerns. The provider had implemented a new app-based system, which all care workers had installed on their smart phones. The system enabled the provider to monitor visits more effectively and to support lone working care staff. The manager told us there had been no missed calls since our last inspection.
People and their relatives told us their care workers were reliable and had never missed a visit. The provider had carried out risk assessments to keep people safe and developed plans to prioritise the delivery of care to those most at risk in the event of an emergency. Staff received training in safeguarding and recognising the signs of abuse. They knew about their responsibilities if they suspected abuse and how to report their concerns. People were protected by the provider’s recruitment procedures. The provider carried out pre-employment checks to ensure they employed suitable people to work at the agency. People’s medicines were managed safely.
People received their care from regular care workers who knew their needs well. Staff had access to the training and support they needed to fulfil their roles. Care workers attended an induction when they joined the agency and shadowed experienced colleagues until the provider was confident in their ability to provide people’s care safely and effectively.
People’s consent was obtained before their care was provided. Where people were did not have capacity to give consent, the provider sought the views of their representatives. The agency worked co-operatively with people’s families to ensure they received the care they needed. Relatives said care workers were observant of any changes in their family member’s needs and that the provider contacted them if they had any concerns about people’s health or welfare. People’s nutritional needs were assessed when they began to use the service. Where people needed assistance with eating and drinking there was a care plan in place to outline the support they required.
People were supported by kind and caring staff. People told us their care workers were polite, courteous and treated them and their property with respect. They said they had developed good relationships with their care workers and looked forward to their visits. Relatives told us that care workers knew their family members preferences about their care and promoted their independence.
People received a service that was responsive to their individual needs. They told us they had been involved in developing their care plans. People and their relatives said their care workers provided care and support flexibly according to their wishes.
People and their relatives had opportunities to give their views about the service and these were listened to. People told us they received surveys and regular contact from the management team to ask for feedback. Any complaints received were recorded and investigated appropriately.
The monitoring and governance of the service had improved with the establishment of a full management team. The management team communicated regularly to ensure all aspects of the service functioned effectively.
Care workers told us the management support they received had improved. They said the management team was supportive and that they could always contact the office if they needed to. The manager had introduced regular team meetings, which aimed to improve communication and promote good practice. A member of the management team regularly carried out spot checks on care workers to observe their practice when caring for people. The manager had taken action to address any shortfalls in care provision.